Prosthetics and orthotics combine science and art to make positive impact
By David Quinn
With archaeological evidence in both ancient Egypt and Iran dating from about 3000 BCE, prosthetics are far from being new arrivals to the human experience. The earliest prosthesis in the historical record seems to be an eye prosthetic, made from bitumen paste covered with a thin layer of gold, found buried with an ancient Iranian woman.
Fast forward more than 5,000 years, and while we might not be coating our modern prosthetic devices with gold, we’re still innovating and combining art and science in ways that are improving people’s lives.
Starting out, changing paths
In the 1970s, Edmonton’s Stan Wlodarczyk started his career in sports medicine and got into the athletic therapy program at the University of Alberta. Ultimately, he spent ten years in that field before realizing where his training and work could have the most impact.
“I came to realize that I was wanting to help more the average working person than the professional athlete,” says Wlodarczyk. “I had the option, and I went with what felt right for me.”
Wlodarczyk earned his diploma in prosthetics and orthotics from New York University School of Medicine and has attained a Fellowship in the American Academy of Orthotists & Prosthetists – the only Canadian to be awarded this highest of honours.
In 1995, Wlodarczyk founded The Prosthetics & Orthotics Care Company in Edmonton and has provided prosthetic services to hundreds of clients since. Over and above his clinic commitments, Wlodarczyk finds the time to lend his expertise and experience in an effort to continue the industry’s innovation.
Managing the pressure
“What we do as prosthetists is a fine combination of science and art,” says Wlodarczyk. Unlike dentistry implants, where you’re talking about going into hard tissue like bone, prosthetics works with the soft tissue – the skin and muscle – trying to stabilize it to provide a secure area through which to carry a load.”
“Even with a hydrostatic socket, where you’ve uniformly pressured up soft tissue to anchor the bone and minimize movement in the socket itself, it still requires good ol’ trial and error and professional experience. We need to know the materials inside and out, and it’s really about how we craft each piece for the individual client.
Innovation at work
Throughout his career, Wlodarczyk has been involved in developing, testing, and improving innovations to prosthetics that give a new sense of confidence to users.
Wlodarczyk was the only prosthetist working in the engineering design process and clinical trials for the prototype of the Ottobock C-leg, the first intelligent microprocessor-controlled knee.
“The knee joint is extremely complex and was often a weak point for prosthetic legs,” says Wlodarczyk. “The strength of the joint really depended on how the user positioned themselves or how they stepped off a curb or stair. It would sometimes just collapse and send the person to the ground.”
“It took about 10 years and hundreds of thousands of dollars, but folks at the University of Alberta’s physiology lab came up with a solution that, despite taking some time for the industry to recognize the value, has become standard issue.”
Wlodarczyk has also spent a good deal of his career working with other folks across North America on developing a system of total surface bearing to manage the loading and forces of the body on the prosthesis. Research into the group’s work is finding that this new way of securing the prosthesis to the remaining limb is even providing a healing environment due to the way it activates fluid distribution into and out of the extremity.
Teamwork that never ends
The prosthetics built and fitted by the team at The Prosthetics & Orthotics Care Company make immensely positive impacts in the lives of patients, but media portrayals of amputees and other prosthetics users – famous or otherwise – can create unrealistic expectations about the work and process.
“How or why the limb was taken matters quite a bit to the recovery and life beyond the initial fitting,” says Wlodarczyk. “Sometimes it’s a loss due to disease or vascular reasons, and sometimes it’s trauma- and/or work-related, so the experience is going be very different for folks.”
Wlodarczyk explains that prosthetics involves team-based care, and the relationship between prosthetist and patient is ongoing and evolving because patients grow, and their lives change.
“The first appointment or fitting is only the start of the work, and it’s not really ever finished,” Wlodarczyk says. “Clients grow and change, and the prosthesis that we build for them needs to grow and change with them, so we’re always revisiting and adjusting things.”
At the end of the day
“The best reward for me, truly, is when my patients get back to living their lives,” says Wlodarczyk. “Yes, life is going to be different and there will need to be changes in most situations, but the folks I see just get on with it, often reaching a point where the prosthesis is just an inconvenience as opposed to something prohibitive to living.”
“When my clients can just get on with living their lives, that’s how I know I’ve made a difference.”